Facility Evaluation Report

On 04/28/2023, Licensing Program Analyst (LPA) A. Walton arrived at the facility unannounced to conduct an Annual Required Inspection. LPA introduced self and stated the purpose of the visit and was allowed to enter the facility by Licensee, Mary Ellen Gurrola, House Manager, Christina Duran-Reyes, and Administrator, Andrea Duran.

There were no residents present during the inspection. LPA conducted a tour of the facility. During the inspection the facility appeared clean and odor free and at a comfortable temperature. Common areas were furnished and had adequate seating and lighting available. Resident bedrooms appeared clean and had required furnishings and adequate lighting. Residents bathrooms appeared clean, water temperature measured at 131.4 degrees F in bathroom 1. Hot water did not reach 105 degrees F in bathroom 2. Facility kitchen appeared to be clean and safe for food preparation. LPA checked the facility food supply.

Exterior tour conducted, all exits open and free of obstructions on today’s visit. Fire extinguisher is current with a service date of 04/21/2023. Smoke detectors and carbon monoxide detector observed to operational. Last fire drill conducted 04/01/2023. Cleaning supplies observed to be locked in a cabinet. LPA reviewed client and staff files. Medications observed to be locked. Medications observed to be administered as prescribed.

A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D.

LPA is requesting the following documents be submitted to the Fresno CCL office by 05/12/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020 ) and Surety Bond

Exit interview conducted and a plan of correction was reviewed and developed. A copy of this report and appeal rights were discussed and provided to Licensee whose signature confirms receipt of this document.